College responds to Williams Review

Written on 14 May 2018.

The Royal College of Physicians and Surgeons of Glasgow have called on the General Medical Council (GMC) to regain the trust of the profession following a series of controversial court cases involving members of the profession.

The call comes in the Royal College’s submission to the Williams Review into gross negligence in healthcare which is published today Monday 14th May 2018. In its submission, the College states that recent court cases have had a considerable impact on the morale of clinicians, and in particular trainees in medical and surgical specialities. It also criticises the regulator for issuing inconsistent advice to junior doctors in the light of the recent Bawa-Garba case, which led to that clinician being struck off the medical register.

Other key points in the College’s submission of evidence include calls for:

A review of whether it is appropriate to maintain gross negligence manslaughter (culpable homicide in Scotland) as a criminal offence in the context of delivering clinical care

Greater accountability for NHS Trusts and Boards where patient safety is compromised through systems failure

A change in the clinical environment to allow for the development of a genuine blame-free medical culture which seeks to learn from mistakes

Speaking as the College published its submission, Professor David Galloway, the President of the Royal College of Physicians and Surgeons of Glasgow said:

“We welcome the establishment of the Williams Review. It’s right that such a process takes place given the implications of recent court cases on the practice of medicine in the UK.

“When mistakes are made, these must be acknowledged and reflected upon in order that lessons can be learned and patient safety enhanced.

“It is vital that we seek to protect individual clinicians for bearing full responsibility in circumstances which are not only highly complex but may involve systematic challenges beyond their immediate control. It is disappointing that the GMC has yet to recognise that systemic issues must to be reviewed and taken into careful consideration in addition to an individual clinician’s performance.

“This is one of the reasons why confidence in the regulator is at an all-time low amongst the profession. The GMC must act now to regain its trust. It’s also of great concern that following the recent High Court ruling on the Bawa-Garba case, the GMC were unable to give consistent advice to trainee doctors as to what they should do if they found themselves in a situation which was unsafe and could bring harm to patients.

“We also believe that there is a strong argument to be made that gross negligence manslaughter, or culpable homicide in Scotland, should not be a criminal offence within the clinical context. There is real merit in the argument of Sir Ian Kennedy QC, who stated that “medical manslaughter means you can pick someone, blame them and imagine you have solved the problem”. This is the wrong approach.

“It is with this in mind that we need to establish how best to ensure that the role system failure in medical negligence cases is properly examined and recorded.

“Most of all, we need to see real leadership within the medical community in order to re-establish a genuine blame free culture in the NHS in order to protect the best interests of patients and clinicians alike.

“That’s why we welcome this process, and look forward to seeing Sir Norman Williams’ report in full when it’s published in due course.”